title: Measuring psychotic depression.
abstract: OBJECTIVE
  Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales and a number of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD.
  
  
  METHODS
  The psychometric properties of the rating scales were evaluated based on data from the Study of Pharmacotherapy of Psychotic Depression.
  
  
  RESULTS
  A rating scale consisting of the 6-item Hamilton melancholia subscale (HAM-D6 ) plus five items from the Brief Psychiatric Rating Scale (BPRS), named the HAMD-BPRS11 , displayed clinical validity (Spearman's correlation coefficient between HAMD-BPRS11 and Clinical Global Impression - Severity (CGI-S) scores = 0.79-0.84), responsiveness (Spearman's correlation coefficient between change in HAMD-BPRS11 and Clinical Global Impression - Improvement (CGI-I) scores = -0.74--0.78) and unidimensionality (Loevinger's coefficient of homogeneity = 0.41) in the evaluation of PD. The HAM-D6 fulfilled the same criteria, whereas the full 17-item Hamilton Depression Scale failed to meet criteria for unidimensionality.
  
  
  CONCLUSIONS
  Our results suggest that the HAMD-BPRS11 is a more valid measure than pure depression scales for evaluating the severity of PD.
authors.affiliation: Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University hospital, Aalborg, Denmark; Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: S D
authors.initials: SD
authors.lastname: Østergaard
authors.forename: B S
authors.initials: BS
authors.lastname: Meyers
authors.forename: A J
authors.initials: AJ
authors.lastname: Flint
authors.forename: B H
authors.initials: BH
authors.lastname: Mulsant
authors.forename: E M
authors.initials: EM
authors.lastname: Whyte
authors.forename: C M
authors.initials: CM
authors.lastname: Ulbricht
authors.forename: P
authors.initials: P
authors.lastname: Bech
authors.forename: A J
authors.initials: AJ
authors.lastname: Rothschild
mesh_terms: D000328:Adult; D000341:Affective Disorders, Psychotic / Q000175:diagnosis* / Q000503:physiopathology; D010054:Brief Psychiatric Rating Scale; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: affective disorders; depression; psychometrics; psychoses